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How many follicles with injectables?

Hi!

I would really appreciate any advice or experiences with injectables. I have PCOS (I ovulate, just ovulate "weakly" due to high LH), and my doctor wants me to start injectables with my next cycle. I'm really worried about multiples. He has me starting on 150 follistim and I'll add in ganirelix. He said he would prefer I have 6-10 mature follicles before triggering! Does this sound like a lot for IUI??? He keeps assuring me that all 6-10 won't fertilize, but I feel like that's such a high risk to take!

Thanks ladies :)


D&C 3/13/15 @ 9 weeks, Turner's Syndrome D&C 9/25/15 @ 7 weeks, normal baby Misoprostol, 1/8/16 @ 7 weeks, Turner's Syndrome AGAIN! Me- 29, PCOS, small septum (removed), stage 3 endometriosis, homozygous MTHFR c677t, ANA + DH- 30, Low-ish count, poor morphology, varicocele TTC #1 since December 2014 January 2015- Natural BFP March 2015- m/c at 9 weeks June 2015- follistim + ganirelix + pregnyl = cancelled, overstimmed July 2015- follistim + ganirelix + pregnyl + iui = BFN August 2015- follistim + ganirelix + pregnyl + iui = BFP September 2015- No heartbeat, d&c October 2015- laparoscopy/hysteroscopy- dx = stage 3 endometriosis, small uterine septum, tubes clear November 2015- follistim + ganirelix + pregnyl = BFP January 2016- Heartbeat gone @ 7 weeks

6 Answers • 8 years ago


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6-10 mature follicles for IUI is a high number in my opinion. This is what many women going through IVF get retrieved at egg retrieval. My dr does not do IUI when more than 3 mature follicles are present. I never get to that point because I get no more than 2 follicles mature. Although not all mature follicles contain viable eggs and not every viable egg gets fertilized or implants, 6-10 mature eggs released will definitely increase the chances for multiples - with or without IUI. IUI cycles get often cancelled because of too many mature follicles. If I were you I would consult with another RE to get a second opinion on this issue. Best wishes.

8 years ago


Thanks for your input, Mozart! I feel like your doctor's opinion not to trigger with more than 3 mature follicles makes sense. My doctor thinks since I had a miscarriage due to a chromosome problem that I'm working with less-than-stellar eggs, and most won't fertilize. But 6-10 seems a little much- I'm only 28! I can't have THAT many bad eggs.


D&C 3/13/15 @ 9 weeks, Turner's Syndrome D&C 9/25/15 @ 7 weeks, normal baby Misoprostol, 1/8/16 @ 7 weeks, Turner's Syndrome AGAIN! Me- 29, PCOS, small septum (removed), stage 3 endometriosis, homozygous MTHFR c677t, ANA + DH- 30, Low-ish count, poor morphology, varicocele TTC #1 since December 2014 January 2015- Natural BFP March 2015- m/c at 9 weeks June 2015- follistim + ganirelix + pregnyl = cancelled, overstimmed July 2015- follistim + ganirelix + pregnyl + iui = BFN August 2015- follistim + ganirelix + pregnyl + iui = BFP September 2015- No heartbeat, d&c October 2015- laparoscopy/hysteroscopy- dx = stage 3 endometriosis, small uterine septum, tubes clear November 2015- follistim + ganirelix + pregnyl = BFP January 2016- Heartbeat gone @ 7 weeks

8 years ago • Post starter


I have PCOS and I normally had 2-4 mature eggs with injectables on my IUI cycles. On 1 of my 4 IUI cycles I had 6 mature follicles and I had to sign a waiver before they would do the IUI saying that I had been informed about the high risk of multiples and had been counseled on selective reduction in the event that a lot of the eggs fertilized and implanted. If selective reduction is something you are willing to do it shouldn't be a problem to go ahead with the IUI with that many mature eggs. If you are against reduction I would not do the IUI. With my 3 IVF rounds my PCOS really went crazy! I retrieved 13, 23 and 24 mature eggs with higher doses of injectables. The doctors are pretty good at controlling the injectable doses so you don't have too few or too many and they gear the doses towards what type of cycle you are doing.

8 years ago


Thanks, mnor! I'm shocked they had you sign a waiver for 6 yet my RE made it seem like that's desirable! There is no way I'm gonna trigger if I have that many. Selective reduction is not an option for me :(- I can't even imagine how traumatic that would be! Wow, that's a TON of follicles - let's hope the docs can control my ovaries pretty well and that doesn't happen to me with IUI. Good luck with your IVF!


D&C 3/13/15 @ 9 weeks, Turner's Syndrome D&C 9/25/15 @ 7 weeks, normal baby Misoprostol, 1/8/16 @ 7 weeks, Turner's Syndrome AGAIN! Me- 29, PCOS, small septum (removed), stage 3 endometriosis, homozygous MTHFR c677t, ANA + DH- 30, Low-ish count, poor morphology, varicocele TTC #1 since December 2014 January 2015- Natural BFP March 2015- m/c at 9 weeks June 2015- follistim + ganirelix + pregnyl = cancelled, overstimmed July 2015- follistim + ganirelix + pregnyl + iui = BFN August 2015- follistim + ganirelix + pregnyl + iui = BFP September 2015- No heartbeat, d&c October 2015- laparoscopy/hysteroscopy- dx = stage 3 endometriosis, small uterine septum, tubes clear November 2015- follistim + ganirelix + pregnyl = BFP January 2016- Heartbeat gone @ 7 weeks

8 years ago • Post starter


Bear in mind this is for IVF.... but I was told that they expect 70% of follicles to produce an egg and 70% of eggs to be fertilised. From 6 follicles, you might get 4 eggs, 3 of which fertilise. From that, maybe one will take, if luck is on your side. I would have thought that fertilisation rates would be much higher for IVF than in IUI, so chances are you'll still need many cycles to succeed. Personally, I'd do some research to try and find more statistics.


5 years TTC. Endometriosis and adenomyosis. Surgery. 2 IVFs. No joy. Low ovarian reserve. Is there any real hope? DE IVF = next step. Much higher success rates, but so used to things not working, it's hard to feel too hopeful. Wishing others an easier time.

8 years ago


Mammoth- Oh man, those sound like such crazy low odds. I just feel like, how does anyone ever get pregnant then, with such low chances? It's crazy! But that's exactly what my RE was suggesting- that out of 6-10 mature follicles, I should be LUCKY to get one or two to stick. I'm relatively young, though (28), so I'm hoping the odds will be in my favor! Not sure what the average age is in IVF studies...but most people I know of who have had IVF are in their mid 30s. I also conceived on my first try naturally (though it was monosomy x and I had a miscarriage). So stressful!


D&C 3/13/15 @ 9 weeks, Turner's Syndrome D&C 9/25/15 @ 7 weeks, normal baby Misoprostol, 1/8/16 @ 7 weeks, Turner's Syndrome AGAIN! Me- 29, PCOS, small septum (removed), stage 3 endometriosis, homozygous MTHFR c677t, ANA + DH- 30, Low-ish count, poor morphology, varicocele TTC #1 since December 2014 January 2015- Natural BFP March 2015- m/c at 9 weeks June 2015- follistim + ganirelix + pregnyl = cancelled, overstimmed July 2015- follistim + ganirelix + pregnyl + iui = BFN August 2015- follistim + ganirelix + pregnyl + iui = BFP September 2015- No heartbeat, d&c October 2015- laparoscopy/hysteroscopy- dx = stage 3 endometriosis, small uterine septum, tubes clear November 2015- follistim + ganirelix + pregnyl = BFP January 2016- Heartbeat gone @ 7 weeks

8 years ago • Post starter


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